Early Weight Loss in Adolescent Weight Management: The Role of the Home Environment

Abstract

Objective: Successful weight loss early in treatment is a key factor for long-term weight management success in adolescence. Yet prior research has not examined factors in the home environment related to risk for increased weight status as potential predictors of early weight management success. The primary goal of the present study was to explore the impact of modifiable household factors on baseline weight status and early weight status change among adolescents participating in an outpatient weight management program to identify clinical targets of early intervention. Method: Parents of adolescents (N = 188) presenting to an interdisciplinary weight management clinic within a children's hospital completed measures at initial presentation. Objective adolescent weight status was collected at baseline and 2-month follow-up (n = 97). Results: Household chaos was significantly associated with weight status at presentation to the clinic, F(3, 181) = 3.85, p = .011. Similarly, household chaos was the only unique predictor of weight change from baseline to 2 months, F(3, 92) = 3.03 p = .033. Conclusions: Household factors, particularly household chaos, have often been overlooked in the adolescent obesity literature but are likely key contributors to early intervention response in a clinical weight management. This study highlights the importance of assessing and intervening on chaos in the household as higher levels of chaos may negatively impact early treatment outcomes among adolescents with obesity. Implications for Impact StatementThe present study suggests that household chaos may be a key modifiable factor impeding adolescent weight loss early in treatment. Although not often considered in prior research, chaos may serve as a key target for future weight management interventions to promote improved outcomes during adolescence.

Adolescents’ reports of chaos within the family home environment: Investigating associations with lifestyle behaviours and obesity

“…Although some studies report direct effects of household chaos on child weight status [ 26 ], others report indirect effects [ 27 ] or no effects [ 28 , 29 ]. One study among adolescents entering a weight management program found higher chaos in the home environment to be associated with higher baseline body mass index and lower short term success in weight loss [ 30 ]. Moreover, sex differences in the association between chaotic home environments and child weight status have been reported in one study of toddlers where an association was found only among boys but not among girls [ 25 ].…”